| NPI | 1932468675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PING PING H DE LUCIA Managing Member 727-215-3963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL DN18757) |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2012-05-15 |